| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
5,395 |
1,880 |
$979K |
| E0295 |
Hosp bed semi-elect w/o matt |
3,633 |
3,633 |
$376K |
| E1399 |
Durable medical equipment mi |
681 |
484 |
$306K |
| K0823 |
Pwc gp 2 std cap chair |
149 |
149 |
$304K |
| K0001 |
Standard wheelchair |
6,296 |
6,293 |
$296K |
| E2361 |
22nf sealed leadacid battery |
1,033 |
1,028 |
$263K |
| E0973 |
W/ch access det adj armrest |
1,172 |
1,157 |
$182K |
| E0143 |
Walker folding wheeled w/o s |
2,300 |
2,298 |
$148K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,853 |
1,819 |
$128K |
| E1028 |
W/c manual swingaway |
503 |
392 |
$94K |
| K0195 |
Elevating whlchair leg rests |
755 |
754 |
$80K |
| E0305 |
Rails bed side half length |
2,056 |
2,055 |
$73K |
| E0630 |
Patient lift hydraulic |
648 |
648 |
$70K |
| K0003 |
Lightweight wheelchair |
451 |
451 |
$68K |
| E0971 |
Wheelchair anti-tipping devi |
1,244 |
1,237 |
$67K |
| E0245 |
Tub stool or bench |
802 |
801 |
$44K |
| K0007 |
Extra heavy duty wheelchair |
153 |
153 |
$44K |
| E0156 |
Walker seat attachment |
2,319 |
2,317 |
$39K |
| E0272 |
Mattress foam rubber |
296 |
296 |
$32K |
| E0978 |
W/c acc,saf belt pelv strap |
1,359 |
1,358 |
$29K |
| E2366 |
Battery charger, single mode |
114 |
114 |
$26K |
| E2601 |
Gen w/c cushion wdth < 22 in |
500 |
497 |
$24K |
| E0303 |
Hosp bed hvy dty xtra wide |
62 |
62 |
$18K |
| K0040 |
Adjustable angle footplate |
121 |
121 |
$16K |
| K0006 |
Heavy duty wheelchair |
145 |
144 |
$13K |
| E2624 |
Adj skin pro/pos cus<22in |
42 |
42 |
$13K |
| E2395 |
Caster wheel excludes tire |
50 |
50 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
402 |
402 |
$7K |
| E0149 |
Heavy duty wheeled walker |
76 |
76 |
$5K |
| E0955 |
Cushioned headrest |
29 |
28 |
$4K |
| E2386 |
Foam filled drive wheel tire |
12 |
12 |
$3K |
| E2394 |
Drive wheel excludes tire |
24 |
24 |
$3K |
| E0163 |
Commode chair with fixed arm |
39 |
39 |
$3K |
| E0961 |
Wheelchair brake extension |
62 |
62 |
$3K |
| E2389 |
Foam caster tire |
25 |
25 |
$3K |
| E0247 |
Trans bench w/wo comm open |
25 |
25 |
$2K |
| E2210 |
Wheelchair bearings |
40 |
38 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
12 |
12 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
56 |
56 |
$766.52 |
| E0241 |
Bath tub wall rail |
26 |
26 |
$752.87 |
| E2213 |
Pneumatic prop tire insert |
12 |
12 |
$717.84 |
| E0244 |
Toilet seat raised |
12 |
12 |
$556.05 |